Healthy Living

Physical Activity and Bone Health

Physical Activity and Bone Health

Exercise and bone density

Regardless of age, exercise and physical activity are an important part of building and maintaining strong, healthy bones. Exercise must be regular and ongoing to have a proper benefit. A good all-around program that incorporates weight-bearing, strength and balance training exercises is most desirable. Weight-bearing and strength exercises are very useful for increasing or maintaining bone mass, while balance training may help with coordination and maintaining muscle mass which can help prevent falls and resulting bone fractures.

Just as using muscles strengthens them, our bones become denser and stronger in response to mechanical stress. This stress primarily comes from weight-bearing exercise (in which your legs support your body) and strength-building exercise (such as weight lifting). For example, if you walk frequently your leg bones will respond by growing stronger. If you play tennis often, your arm bones will respond by increasing their mass.

Exercise is important at different stages of life

In children exercise helps growing bones to become as strong as possible to help minimise the impact of bone loss as we grow older. Exercise also maintains bone health in adulthood, helps to prevent or slow bone loss after menopause and helps to improve balance and co-ordination in the elderly to reduce the risk of falls. Exercise can also help speed rehabilitation following a fracture.

Research studies on exercise and Bone health have shown that:
Children who participate in moderate to high impact weight-bearing exercises, for example, hopping, skipping and jumping, have higher bone density compared to less active children.

For adults, a combination of progressive resistance training with a variety of moderate impact weight-bearing activities is most effective for increasing bone density or preventing the bone loss that occurs as we age.
For older adults (over the age of 65) Hip fractures have been found to be as much as 38-45% lower in older adults who have been physically active in their daily life, compared to less active people.

Weight-bearing exercise is any exercise in which you are supporting your own body weight through
your feet and legs (or hands and arms).

The right kind of exercise

Specific types of exercise are important for improving bone strength. Bones become stronger when a certain amount of impact or extra strain is placed on the bones. Exercises recommended for bone health include:
  •  Weight-bearing aerobic exercise -for example, brisk walking, jogging and stair climbing.
  •  Progressive resistance training -for example, lifting weights that become more challenging over time
  •  Moderate to high impact weight bearing exercise -for example, jumping, skipping, dancing, basketball and tennis
  •  Balance and mobility exercise. While not improving bone or muscle strength, these exercises can help to reduce falls -for example, standing on one leg with the eyes closed, heel-to-toe walking

Children should undertake 60 minutes of moderate-intensity physical activity each day.
Adults should be doing 30 minutes of moderate-intensity physical activity at least five days a week (or 150 minutes or more in total). They should also undertake physical activity to improve muscle strength on at least two days a week.
Older adults who are at risk of falls should also incorporate specific exercises to improve balance and co-ordination on at least two days a week and reduce the amount of time spent being sedentary (sitting) for extended periods.

Getting the most out of your exercise

Regular weight-bearing exercise including exercise at moderate to high impact, as well as resistance training, is recommended. Some exercises are better at building bones than others. The ability of an exercise to build bone (its osteogenic capacity) depends on the specific way that stress is applied to the bone during the exercise.

  •  Exercise must be regular: At least 3 times per week.
  •  Exercise should progress over time: The amount of weight used, degree of exercise difficulty, height of jumps, etc. must increase or vary over time to challenge the bones and muscles
  •  Exercise routines should be varied: Variety in routines is better than repetition.
  •  Exercise should be performed in short, intensive bursts: Regular short bouts of weight-bearing exercise separated by several hours are better than one long session. Lifting weights quickly is more effective for improving muscle function than lifting them slowly. Rapid, short bursts of movement such as jumping or skipping are more effective than slow movements. If exercise needs to be reduced, it is better to reduce the length of each session rather than the number of sessions per week

The impact of selected exercises on bone health

Highly osteogenic Moderately osteogenic Low osteogenic* Non-osteogenic*
Basketball /Volleybal Running /Jogging Leisure walking Swimming
Impact aerobics /Jump rope Brisk /Hill walking Lawn bowls Cycling
Dancing /Gymnastic
Resistance training
Stair climbing
Yoga /Pilates /Tai Chi  

*While some exercises may have low to no osteogenic benefits, this does not imply that these exercises do not offer a wide range of other health benefits.